Maintaining Unity - relatives in older patients' fast-track treatment programmes. A grounded theory study

Area of Science:

• Geriatric Medicine
• Orthopaedic Surgery
• Qualitative Research

Background:

• Fast-track treatment programs enhance efficiency in total hip and knee replacements.
• Family support is crucial for older patients' recovery trajectories.
• Understanding relatives' behavioral patterns is needed to optimize their role in fast-track programs.

Purpose of the Study:

• To develop a grounded theory explaining relatives' behavior patterns in older patients' fast-track treatment programs.
• To identify how relatives support elderly patients undergoing hip or knee replacement.

Main Methods:

• A Glaserian grounded theory approach was employed.
• Data collection involved non-participant observations and interviews with seven relatives of patients over 70.
• The constant comparative method guided simultaneous data collection, analysis, coding, theoretical sampling, and memo writing.

Main Results:

• The core pattern of behavior identified was 'Maintaining Unity', addressing the main concern of preventing patient loneliness.
• Relatives utilized three interchangeable modes: Protecting (loving support), Substituting (practical/cognitive aid), and Adapting (fitting in with care requirements).
• This pattern reflects a strong desire to provide compassionate care.

Conclusions:

• The 'Maintaining Unity' theory illuminates relatives' commitment to providing supportive care during fast-track joint replacement recovery.
• Findings emphasize the significant role of family in enhancing patient experience and outcomes in enhanced recovery pathways.